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Biomedical subjects

B Fagrell

Publications and source records attributed to B Fagrell.

At least 109 records · Page 6Linked to original sources
PubMed1979

Non-invasive beat-to-beat analysis of stroke volume and digital pulse volume in patients with complete heart block and artificial pacing.

This study presents a beat-to-beat analysis of digital arterial pulse volume (DAPA), left ventricular end-diastolic diameter (LVEDD), and stroke volume (SV) and their correlation to PQ interval in ten patients with complete heart block and artificial cardiac pacing. DAPA was measured by strain-gauge plethysmography and LVEDD/SV by echocardiography. A close relationship was found between SV and DAPA (R = 0.83-0.97) in seven patients, who all drew considerable benefit from atrial contraction as regards SV and DAPA (increase with 35-94%). The optimal PQ interval was calculated to approximately 240 msec for DAPA and 180 msec for LVEDD and SV. It may be concluded that the present study demonstrates a close relationship between beat-to-beat variations of SV measured by echocardiography and plethysmographically recorded digital arterial pulse volume. These variables may be useful in clinical practice for assessing the hemodynamic effect of atrial contribution in patients with various forms of cardiac conduction disturbances. The two methods may, for instance, be useful for screening in order to pick out patients who may benefit from AV synchronous rather than ventricular pacing.

Adult↗
PubMed1978

Non-invasive methods for evaluating the importance of heart rate and atrial activity in cardiac pacing. Results of ballistocardiography and digital plethysmography studies in six patients with heart block.

Ultralow frequency ballistocardiography (UFB) and digital pulse plethysmography (DPP) were performed in six patients with an external artificial pacemaker system. UFB was used mainly to evaluate the force of contraction of the left ventricle (IJ amplitude) and DPP for evaluating relative changes in the peripheral pulse volume. Four patients were studied at 40, 50, 60, 70, 80, 90 and 100 beats/min. There was a significant decrease (p less than 0.001) in LJ and pulse amplitudes when the heart rate increased from 40 to 100 beats/min. A positive correlation between relative IJ and pulse amplitude was observed in all cases studied. In beat-to-beat analysis it was found that the importance of the PR interval for the IJ and pulse amplitudes varied between patients. It is concluded that both UFB and DPP may be of value in clinical practice for evaluating hemodynamics in patients with slow spontaneous heart rate. The methods may be of help in selecting the most effective type of pacemaker for the individual patient.

Aged↗
PubMed1978

Polycythemia vera as a cause of ischemic digital necrosis.

Two patients with polycythemia vera and peripheral gangrene as the only clinical sign of the disease are described. No concomitant arterial insufficiency was present. The need for an early correct diagnosis in such cases is underlined. Reduction of the blood volume and cytostatic treatment are sufficient and no surgical intervention is required.

Adult↗
PubMed1977

Deleterious effects of cardiac pacing in a patient with mitral insufficiency.

A 70-year-old, artificially paced women with dizziness and extremely low physical capacity exhibited a systolic BP varying from one moment to another; in standing position it was not measurable. With the aid of a strain gauge technique, the amplitude of the pulse wave of her left thumb was recorded and shown to vary widely. The variations were correlated to synchrony or asynchrony between atrial and ventricular activity. Pronounced decreases in stroke volume and peripheral pulse volume were recorded with pacemaker-induced beats compared with idioventricular beats. With artifical stimulation at a rate of 45/min, thus avoiding competition but still protecting her from syncopes, she was free from symptoms.

Aged↗
PubMed1977

A microscope-television system for studying flow velocity in human skin capillaries.

A noninvasive technique for studying blood flow dynamics in human skin capillaries is described. A light microscope combined with a closed-circuit TV system was used to monitor and record capillary blood flow velocity on video tape. Arterial pulsations were recorded plethysmographically and converted into video signals by modulating the position of a square, white area in the televised scene. Twelve healthy subjects were studied. The mean (+/- SD) resting capillary blood flow velocity was 0.65 +/- 0.3 mm/s at an average skin temperature of 30.4 +/- 2.3 degrees C. Spontaneous fluctuations at a frequency of 6-10 cycles/min were observed in most subjects. A well-pronounced flow pulsatile component could be demonstrated in all capillaries studied. The technique can be used in clinical practice for studying the physiology and pathophysiology of cutaneous microcirculation in man. It can be expected that the method may become an important diagnostic tool in diseases that involve disturbances of the microcirculation, such as diabetes, hypertension, and atherosclerosis.

Capillaries↗
PubMed1976

A nitrofurantoin-induced disorder simulating chronic active hepatitis. A case report.

A 78-year-old woman with liver damage resembling chronic active hepatitis and occuring during long-term nitrofurantoin treatment is described. On admission to hospital she displayed jaundice, ascites and high serum levels of GOT, GPT, bilirubin and gamma-globulin as well as high titres of ANF and antibodies against smooth muscle cells. After withdrawal of nitrofurantoin the clinical and laboratory picture normalized without corticosteroid treatment, suggesting that the liver reaction was drug-induced.

Aged↗
PubMed1976

The value of an oscilloscope in routine checking of pacemakers.

An evaluation has been made of the usefulness of the oscilloscope at routine check-ups of cardiac pacemakers. Measurements of 100 consecutive implanted pacemakers, obtained after their removal have been compared with changes in rate and changes in impulse duration and amplitude obtained at previous routine controls. Other changes in pacemaker characteristics have also been evaluated. Eight faulty pacemakers were found. Six had a decreased voltage, none however, less than 3.5 volts. Five of them had shown a decrease in rate by at least 7 impulses per minute, while in one QRS-synchronized pacemaker the synchronizing circuit did not function. In one pacemaker the stimulating rate had increased with 20 impulses while in one P-synchronized pacemaker the delay time had decreased. In 6 patients a significant decrease of the impulse amplitude was noticed without fall in voltage or electronic failure and in 3 others no decrease of the impulse duration was noticed in spite of decreased voltage at check after explantation. The present study therefore indicates that, at routine check-ups of the presently analyzed pacemakers with voltage depending stimulation rate, an analysis of the latter gives satisfactory information of pacemaker function and can be used instead of oscilloscope test, eventually in combination with electronic measurements of impulse duration.

Evaluation Studies as Topic↗
PubMed1976

Subcutaneous arteriovenous fistulas for dialysis with special emphasis on vascular insufficiency.

Ninety-four subcutaneous arterio-venous fistulas were created for haemodialysis in 83 patients. Seventy-one patients eventually received well-functioning fistulas. The most common complication was thrombosis at the suture line. Thus, 8 primary fistulas clotted within 24 hours of surgery and 5 clotted later. Eleven patients were reoperated with a successful result in six. One patient developed arterial insufficiency in the hand with finger ulcerations, probably due to a radial steal syndrome. Four patients got extremely swollen hands and threatening gangraena because of thrombosis of the vein proximally to the anastomosis. Vital capillary microscopy in the patients with vascular insufficiency demonstrated profound changes of the nutritional capillaries which were not seen in control patients with well-functioning fistulas. After closure of the fistulas the edema disappeared and the ulcerations healed rapidly.

Adult↗